Guided Imagery on Cracking

the Placebo Code

Guided Imagery on cracking the placebo code

Good luck, Placebos and crossing your fingers!

What’s a placebo have to do with guided imagery? Have you ever wondered if crossing your

fingers is good luck especially when your doctor does it? Do you care? Is the placebo effect a

vital force in a complex system that can be tapped into? And how do we put a face on its

value and healing in light of evidence-based medicine? Is there a role to be played through

guided imagery, a deeper visual vocabulary, or a metaphoric iconic symbol? Appreciating that

many friends have short windows to engage in such topics and others needing more there is

a summary in the final paragraph for those of you who are inclined to right brain material.

Interested, then start by reading a few lines from this NY Times review!

What’s luck got to do with it? Mindful healing

In preparing for this blog on the placebo I was reading in the 8/29 NY Times book review

section, Melanie Thernstrom’s (The Pain Chronicles: Cures, Myths, Mysteries) where she

recalled an interaction she once had which has stayed with her and is recounted in her book

“I had gone to the clinic early in the morning for a test that would reveal the treatment I had

undergone with this doctor had succeeded. As I was leaving the clinic, I glimpsed the doctor

across the reception desk, on the far side of the room. He held up his hands, crossed his

fingers. He was wishing me luck, reminding me the treatment was over, my faith was now up

to chance, for (powerful though he was in my mind) he did not possess the kind of power

that determines lab results. But he was also telling me that he had hoped that chance went

my way". The reviewer noted in the article" The Pain Chronicles" “ if you don't believe your

physician understands your pain, why bother with the monstrous physical therapy and

countless pills she prescribes? Those skeptical of many alternative therapies (researchers

found most of them to work as placebos) Thernstrom noted the practitioners’ force of

personality. “They all possess some kind of personal power; they knew how to invoke

belief, and their patients

actually followed their suggestions,” she writes. Anyone can deliver prognosis or relay facts, but

not everyone can persuade a mind to believe the body can heal. The review's ends by stating,

“There is no simple recipe for healing. Yes some people including Thernstrom herself learn to

manage medication or train their brains to modulate the perception of pain through

neuroimaging. Their successes, recounted so meticulously here, will surely prove useful to

others. But "The Pain Chronicles" is no mere self-help manual. It's a sophisticated, elegant

compiled treatise.”

A different mental universe

Here the main point is in seeing placebos as mental universes and finding new constructs, new

avenues that inform and transform us and the wealth in having access to some elegant

navigational maps as well as creating our own. One such map and map maker for broadening

mental-scapes is Christopher Alexander and in his living whole systems from an applied arts

field of architecture (Vision-Living-World-Nature- Alexander). His comments are applicable

regarding the theoretical science of medicine and complementary alternative medicine “science

only tells us about facts. When it comes to figuring out what one ought to do, that is a private

matter of ethics. It is your natural right to work out your own values. Not only will our

scientific world–view not tell you anything about value, it is your democratic obligation to do it

for yourself " he continues "what we need is a shareable point of view, in which the many

factors influencing healing can coexist coherently, so that we can work together–not by

confrontation and argument–but because we share a single holistic view of the unitary goal of

life" ... " then this new view will show us the world is an altogether different kind of place from

the one we have imagined. When this happens not only will things look different things will

appear to us as fresh and marvelous. We shall, then, literally, be living in a different mental

universe." (ed. a mental universe that embodies energy systems that can be tapped into).

How then do we enter into this different mental universe? What we need is a broader and

more adequate definition of life, of healing, of self–will! A new concept of life, a new

feeling of life as in organisms, a new feeling of life as an ecological system, a new feeling of life

as in patterns, as in colors, as in textures, essence, smells, a new definition of life that is

biologically healthy, a melted unity - this deepest experience of order that we experience with

wonder which is the real essence of wholeness, the quality which we are most often trying to

reach when we aspire to wellness and health. It is in fact this redefinition when integrated into

thinking and beliefs – influencing ultimately our actions- that that will swing the gates between

evidence-based and value-based research both ways. We are already seeing one dimension of

this deep witnessing to a degree in Mindfulness Therapy. This new century will be a century of

cooperation and integration. The Placebo concept will reorder our perceptions of

empowerment, and transform our identities into healers. This transformation will deepen

language much as the ocean deepens our consciousness as a metaphor. We will no longer be

bound by evidence-based constraints that are skewed models but will expand into this

system’s worldview as being "alive" because whole systems embody adaptation.

Informed guided imagery: A Dancing Iconic Feminine

Medically speaking when confronted with evidence-based research regarding whole systems

the new order will elegantly address the patterns, which influence wholeness, harmony, and

beauty; a deep symmetry that metaphorically speaking dances between spirit and matter in a

creative iconic feminine. The term Alexander uses is centers: As a first approximation, a “center”

may be defined as a psychological entity which is perceived as a whole, and which creates the feeling

of a center, in the visual field. (ed. the imaginal field). Guided Imagery asks us to imagine and

embody the imagining, a kind of deep cellular seeing. Finally we have a sequence to deep see.

A creative force that is shared by Alexander has four Key ideas:

- Living structures are in themselves centers (ed. cells).

- Centers themselves have life.

- Centers help one another: the existence and life of one center can intensify the life of

another.

- Centers are made of centers (this is the only way of describing the composition).

A structure gets its life according to the density and intensity of centers, which have been

formed, in it. The beauty here is that we live in a world that holistically as an eco-system is a

living system that not need be abstracted or scripted. It is living and we are living in it!

These four points, simple as they are by Alexander, give us a useful schematic of living structure,

and of the way life comes from wholeness. Patterns that can embody imaginative inner

landscapes, tools for inner crafting deep pathways into energies for nurturing and recovery that

are then a ground for imagery constructs that take guided imagery into deeper realms of

creative expression which have at their center alive energy. A sequenced guided imagery

incorporating patterns that return living systems to centers and wholeness.

Healing is an active principle and is congruent with the placebo in that they both share a mental

congruence. The informed mind as a center creates other bodymind centers that move towards

wholeness when experienced harmoniously and balanced. The Placebo effect is also a patterned

active system, a whole system with its centers. Not a mysterious force that can be swept away

by rigid doubters, or fundamentalists that are bound to theoretical evidence-based science.

Evidence–based science too is in itself a system seeking the elegance of integration, harmony

and balance, a system of patterns, centers and wholeness. In mindfulness we are reminded to be

the witness so here too can we witness the deep relationship of whole systems. As a

community of healers all beings are living whole systems that can lay down a path for healing

and living.

Then, if there is congruence in these ideas there can then be a new playbook to engage these

ideas of centers and wholeness, iconic symbols and new tools to deepen healing and wellness

through guided imagery - tools that the guided imagery collective is focused on exploring with

other therapists and practitioners.

Swinging gates allow for entering and exiting

This final paragraph is wonderfully stated for the practitioner. As stated earlier the gate is

beginning to swing both ways regarding placebo response and evidence-based findings,

www.guidedimagerycollective.org

In this new book “Imagination and Medicine”, which is scheduled for review in our resource section

(Imagination and Medicine-Stephen-Aizenstat) we find a fitting conclusion. “Careful experimental

manipulations have the power to provide strong evidence of active placebo responses, refuting

assertions that placebo effects are nothing but reporting biases and statistical artifacts. The cortical

and sub cortical regions involved in and affect an evaluation are indeed able to modulate peripheral

outcomes, providing candidate mechanisms that may support placebo responses across a range of

disorders and clinical conditions. These placebo response mechanisms are presumably at work in

active behavioral and pharmacological therapies as well. These mechanisms elucidated by experimental

research on the placebo response thereby provide a powerful window into understanding how the

brain is capable of modulating the body’s physiological state.”

We will continue to address this controversy and invite your comments!

“Once we have built the gate, we can pass through it to the practice of the

timeless way”. Alexander

Notes: Lauren Y. Atlas and Tor D.Wager’s chapter “The Neural Bases of Placebo Effects in Pain” in

“Imagination and Medicine” by Stephen Aizenstat and Robert Bosnak. 2009

Vision-Living-World-Nature- Alexander,

Imagination-Medicine-Stephen-Aizenstat

Pain-Chronicles-Mysteries-Prayers-Suffering